Diabetes in Fiction: Good Like This by Peter Arpesella

In Peter Arpesella’s debut novel, Good Like This, we see diabetes bare and tumultuous. Any person with diabetes will relate, whether to the relentless requirements of care, the seeming impossibility of taking just the right amount of insulin, the shame, the awkward moments, the proliferation of syringes, the reliance on technology, the technological malfunctions, and the spectrum of relationships with medical professionals, from mutually supportive to outright adversarial.

But Good Like This isn’t only about the negative side of diabetes. In the novel’s end, triumphant while humble and down-to-earth, we witness the power of a practiced, balanced mind to manage the diabetic condition as best as possible. Happiness, health, and peace prevail as the protagonist Paul rebuilds his life with the support of the right doctor, his family, and his community.

I had a chance to ask Peter Arpesella a few questions about his life in connection with his first novel.

First, tell us a bit about yourself. How long have you had diabetes? What was it like when you were diagnosed, and how has your relationship with diabetes changed over the years?

I am originally from Italy. I got diabetes when I was seven years old. Back then, especially in my little town of Rimini, it was like an anomaly of sorts. Nobody had it. Nobody had it in my family.

I do believe there is strong emotional component to getting diabetes, certainly in my case. I was very attached to my parents, and they were going through hell, and not in a good way. While the family was beautiful from the outside, from the inside, it was very emotionally intense. I have a feeling that the way I dealt with this turmoil, internalizing it and locking into myself, was one of the components that led to diabetes.

Peter Arpesella

On a physical level, I got mumps, and that affected my pancreas. I got pancreatitis and that turned into Type 1 diabetes. But, without the emotional turmoil, there’s a good change mumps would’ve just come and gone.

It was much more difficult and traumatic for my parents than it was for me. As a child, you only know what’s happening right then and there. At least, that’s how it was for me. I didn’t know what it all meant.

When I was told it was something I would have for my entire life, I said, “Well, OK.”

I had a nurse coming every day to give me the injections. After the first week, I said, “I’m going to have this thing for the rest of my life, so I might as well start taking care of it for myself.” So I took the syringe and gave myself my first shot.

My diabetes was never a secret; I never felt like I had to hide. My father and mother were my buddies in this experience. They really did a phenomenal job putting aside their fear, their pain, their trauma, and making the best for me.

I am lucky in many ways because, diabetes or not, my mother especially always said, you have to eat healthy and you have to exercise. So I was always doing sports. I loved sailing, I made it onto the Junior National sailing team in Italy.

The doctors said, “You can’t sail alone.”

I thought, “We’ll see about that.”

My father said, “Maybe we have to get organized and you can sail alone. Maybe we tell the team that you have diabetes and you’ve got to have your sugar with you in a watertight place, and, off you go.”

So, off you went?

I was lucky because my parents supported my independent spirit. I never believed that I could not do something because of diabetes; I just had to work a little more. I was lucky because I had a healthy upbringing. There was no fast food or overeating.

In my teen years, I was OK. I also feel that while my friends were getting drunk and high, my diabetes kept me grounded. I never found myself as a teenager feeling a desire to even try these things. I was happy to sail.

Then, in my 20s, after my father’s violent death, I took a bend for the unhealthy lifestyle. I started working, and in my late 20s, I did what people usually do in their teen years. I started drinking and getting high. Again, this was never my thing, so I was never really at risk of, you know, losing myself. But I did it. And diabetes was like an afterthought.

An afterthought, but still a thought. Diabetes kept me grounded. I always say that diabetes saved my life, because otherwise, maybe I would have put the pedal to the metal and really pushed the life of excess with alcohol and drugs and really hurt myself. But that didn’t happen because somewhere in the back of my head, there was diabetes, even though I went in a hypoglycemic coma four different times while I was drinking and dancing and overcompensating with insulin.

After that, I changed my life and changed my profession. I became an actor and writer. My relationship with diabetes changed because it wasn’t any more an element of my relationship with my parents, or something that I just had in my teen years, or something that I was using to show off while living like a rock star.

In my 30s, I said, “Well, diabetes is with me for the long haul, and I have my best relationships with my friends. It’s not a horrible disease, it’s not something I have to conquer or destroy, it’s not an obstacle that I have to surpass. Maybe it’s just something I learn to happily live with, like a friend.” And that changed my life.

From then on out, I lived better. I changed my nutrition. The retinopathy went away. And I started living a healthy life.

Why did you write Good Like This?

The inspiration came when I was in New York City and the cameras were following the New York City Marathon. It was the final few miles, and it was the lead group of women and men. And for some reason, I started crying. Just bawling my eyes out.

I saw their essence, running toward this goal, with nothing but themselves, their shoes, and very few clothes!

So, I thought, I have to write something about this.

Isn’t it interesting that the marathon requires a certain mental and physical attitude that could be a metaphor for a life with diabetes? In diabetes, you don’t do well if you just take care of yourself for a year. You do well if you take care of yourself every day for the rest of your life.

It is the same with a marathon. In a marathon, if they have a great start, it doesn’t matter if they make poor choices along the way.

With this inspiration, I wanted to write something that was passionate and entertaining. I wanted to write a story. I hadn’t seen or heard or read great stories where diabetes is an element of positive change and transformation.

I thought, “Well, diabetes has been a little bit of a life teacher for me.” I learned about myself through diabetes. I learned what I do when there is something in life that stresses me out. If there’s a person that stresses me out, I see it in my blood sugar levels.

With diabetes, I constantly have to keep it real. I constantly have to face my truth. It really forced me to have a real, open, honest dialogue with myself. This is a good element of the story, and it will shed a different light on this condition that for so many is considered a stigma, a curse, something extraordinarily negative.

Perhaps, if we reexamine the nuts and bolts of diabetes, we can say, “OK, I have an organ that’s not doing its job. What I can do is live healthily, eat healthily, exercise, and take care of myself.” So I decided to write a different story with this point of view about this condition.

Have you always been open and public about having diabetes, or were you reluctant to share this fact about yourself for social or professional reasons, just like Paul? How do people usually react when they find out that you have diabetes?

I decided to make this [secrecy around diabetes] a big character trait with Paul because I see that for a lot of people, be it diabetes or seizures or any other condition that comes with a little bit of stigma, there is a tremendous tendency to keep it secret.

In my life, I never really made it a secret or was ashamed of having diabetes. But sometimes I wouldn’t say anything about it. So, for example, working as an actor on set, when the camera was rolling and I went into hypoglycemia, no one knew that I had diabetes. I wondered if people would get pissed because I was delaying the shooting schedule, so I didn’t say anything. And that’s ridiculous. It’s idiotic. And I couldn’t do the work well, unless it was a scene as a junkie, and then it would have been perfect.

When I went on a set or a new social environment, like when I raced on a boat, I would never say, “Guys, as a point of info, I have Type 1 diabetes, so if you see me foggy, or silent, or if I don’t make much sense, tell me to check my blood sugar and eat something, because that’s what I need.” I never would have said that. And as it turns out, several times, I went into deep hypoglycemia, and they had to find their way to get out of it because I didn’t give them instructions. But it is my responsibility to inform them. Not to scare them or alarm them, not to be the center of attention – just to inform them, because it’s my responsibility. And then we can go on with our sailing day, or our work.

I did change. I made it part of my process to share this necessary information when the situation calls for it because it is my responsibility to do so.

Invariably people are happy when I share this information with them. They feel that I respect and trust them. If they have questions they ask. Often they share something about themselves, or a friend, or a loved one. They welcome me, immediately, because I come across responsible and real.

Your descriptions of Paul’s experiences as a diabetic are vivid and personal. To what extent is Good Like This autobiographical?

Definitely, this is not an autobiography. Definitely, this is pure fiction. But as you might have heard, we write what we know. What I do know is the emotional condition of these characters. Because in one way or another, I’ve found myself in their shoes. So I gave them what I know about that emotional condition.

For Paul, of course, the canvas for me is larger. At moments, writing it was really, really intense. I said, “If I want to reach people’s minds and hearts, I have to give my mind and heart without limitations.”

So, for example, when I wrote how it feels when you indulge in hypoglycemia, losing the reality, it was shameful for me because if I am capable of writing it, it means that I have allowed myself to experience these things. But it is not autobiography. The story of this New York family is of these characters. Their reality, their pathos, and their passionate and unexpected ups and downs are all their own.

What is one of the toughest things about having diabetes today, and how do you handle it?

On one hand, there’s never an off switch. It’s a marathon. I just have to be constantly on. But then again, isn’t it like this with anything in life?

Now that I’ve taken care of myself for so long, and for the millions of people that either are getting diabetes now or have had diabetes for a while, I would love if there could be a permanent, good solution. And so the blurriness in that arena is sometimes tiring for me. It would be better if the big pharmaceutical companies spent even just 10% of what they spend for product research for diabetes and put it into either their own, or, better yet, somebody else’s cure-related research so we can find something that is an intelligent solution for this..

And then I would like the attitude about diabetes to be changed. It’s a condition that forces us to be healthy and honest with ourselves. What’s so wrong with that?

What’s your favorite food?

Salad.

Tell me about this salad!

Again, this is one of the gifts from my mother. She wasn’t a good cook, and one thing that was always easy to prepare was a salad. So I ate salad every day of my life. Even if I ate an entire gigantic jar of Nutella with a spoon, which I did, several times, I would always also eat a salad.

Salad saved my life. I am vegan, but I eat fish. I don’t need to have fish in salad for it to be my favorite food. I certainly like carrots and almonds and nuts and all kinds of lettuce and arugula and all of these things and … I get happy just thinking about them!

And I dress it only with olive oil and pepper.

What about balsamic vinegar?

Yes, that too, sometimes. But it’s not necessary.

How do you feel about having a superpower? This is a concept that you discuss in Good Like This – that diabetes is like a superpower.

My superpower is to be healthy and constantly in touch with myself. Diabetes is a built-in mechanism that requires me to be honest with myself. I can’t be in denial. I can make mistakes, of course, because I am a human being. But I cannot be in denial.

So if I do something that is “wrong” or not advisable, I say, “OK, I know that it would be better if I didn’t do this. I am aware that this is something that will require further action on my part, to compensate.”

My relationship with myself, if I look at diabetes in this way, is honest by necessity, by nature. This is how I have to be. And I think this is a heck of a superpower. Because the second one is honest with oneself and comfortable with it, that is what self-confidence is about. On the physical side, diabetes requires me to keep it real and live a healthy lifestyle. On the emotional and psychological side, it requires me to keep it real on an emotional level.

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Very few protagonists in contemporary adult literature have struggled with diabetes, even though the experience intersects with the timeless themes, like desire, identity, mortality, pain, and even triumph.

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